To the editor(s) and contributors at KevinMD,
We are responding to an article titled “Independent practice: Both nurse practitioners and physicians should be outraged” (January 5) on behalf of the American Association of Nurse Practitioners (AANP), the National Association of Pediatric Nurse Practitioners (NAPNAP), and the National Organization of Nurse Practitioner Faculties (NONPF).
As nurse practitioners (NPs) and nurse educators, we find your view of our profession quite troubling and frankly, out of touch with both current research and the realities of health care delivery today.
Your premise that NPs and their organizations desire to turn “nurses” into “doctors” grossly misstates our goals and marginalizes the unique skills and experience NPs bring to health care. Rather than serve as “carbon copies” of our physician counterparts, our clinical experience and education prepares us to diagnose and treat health conditions with an emphasis on disease prevention and health management.
Despite the country’s well-documented health care access crisis and the skyrocketing incidence of chronic disease, the physician lobby continually chooses to uphold the status quo, stalling legislation that grants patients direct access to their health care provider of choice – including nurse practitioners.
The reason is simple: In a declining number of states, physicians enjoy a direct financial and competitive benefit codified into state law, referred to as a “collaborative agreement.” Under state law in 28 states, in order for a patient to obtain care directly from a nurse practitioner, the provider must hold a “collaborative agreement” with a physician. Contrary to claims made by the physician lobby, these agreements don’t improve care coordination or improve consultations between providers. Largely, they serve as financial vehicles designed to profit physicians.
Over 1.6 million Americans already choose NPs as their primary health care providers, and the NP profession is among the fastest growing health care jobs in the United States. Hospitals, private clinics – and frankly – physician practices nationwide recognize the unique value we bring to patient care. Your article not only misrepresents both the policies nurse practitioners are advancing at the state level, it misstates more than 50 years of research that demonstrates the outstanding quality of care nurse practitioners provide patients nationwide.
In response to your suggestion that nurses are entering programs with “100 percent” acceptance rates to become NPs, the hyperlink to 100 percent acceptance rates refers to master’s programs, not Doctor of Nursing Practice programs. Moreover, the 10 programs are not necessarily NP programs. The misrepresentation of "bridge programs", suggesting that work experience rather than prior earned academic credentials is the foundation for educational progression, undermines the value of undergraduate education that nurses as well as physicians and other health care professionals achieve before entering the next step of their academic career. We also find it curious that your wildest and most egregious claims are not sourced.
While we understand that this is a physician led outlet, we hope the physician community will stop the rhetoric aimed at undermining patient access and choice in health care.
Physicians, nurse practitioners and other providers should be working together to solve the many health care issues facing our country. If we work together, we can increase access to the health care our patients deserve.
We look forward to your response.
CEO, American Association of Nurse Practitioners
Catherine Brennan, MBA, CAE
Executive Director, National Association of Pediatric Nurse Practitioners
Mary Beth Bigley, DrPH, APRN, FAAN
CEO, National Organization of Nurse Practitioner Faculties